中性粒细胞减少性小肠结肠炎与脓毒症:迈向病理特征的定义
Neutropenic Enterocolitis and Sepsis: Towards the Definition of a Pathologic Profile.
作者信息
Bertozzi Giuseppe, Maiese Aniello, Passaro Giovanna, Tosoni Alberto, Mirijello Antonio, Simone Stefania De, Baldari Benedetta, Cipolloni Luigi, La Russa Raffaele
机构信息
Section of Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Ospedale Colonnello D'Avanzo, Viale Europa 12, 71100 Foggia, Italy.
Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy.
出版信息
Medicina (Kaunas). 2021 Jun 20;57(6):638. doi: 10.3390/medicina57060638.
Neutropenic enterocolitis (NE), which in the past was also known as typhlitis or ileocecal syndrome for the segment of the gastrointestinal tract most affected, is a nosological entity that is difficult to diagnose and whose pathogenesis is not fully known to date. Initially described in pediatric patients with leukemic diseases, it has been gradually reported in adults with hematological malignancies and non-hematological conditions, such as leukemia, lymphoma, multiple myeloma, aplastic anemia, and also myelodysplastic syndromes, as well as being associated with other immunosuppressive causes such as AIDS treatment, therapy for solid tumors, and organ transplantation. Therefore, it is associated with high mortality due to the rapid evolution in worse clinical pictures: rapid progression to ischemia, necrosis, hemorrhage, perforation, multisystem organ failure, and sepsis. : A case report is included to exemplify the clinical profile of patients with NE who develop sepsis. : To identify a specific profile of subjects affected by neutropenic enterocolitis and the entity of the clinical condition most frequently associated with septic evolution, a systematic review of the literature was conducted. The inclusion criteria were as follows: English language, full-text availability, human subjects, and adult subjects. Finally, the papers were selected after the evaluation of the title and abstract to evaluate their congruity with the subject of this manuscript. Following these procedures, 19 eligible empirical studies were included in the present review. : Despite the recent interest and the growing number of publications targeting sepsis and intending to identify biomarkers useful for its diagnosis, prognosis, and for the understanding of its pathogenesis, and especially for multi-organ dysfunction, and despite the extensive research period of the literature review, the number of publications on the topic "neutropenic enterocolitis and sepsis" appears to be very small. In any case, the extrapolated data allowed us to conclude that the integration of medical history, clinical and laboratory data, radiological imaging, and macroscopic and histological investigations can allow us to identify a specific pathological profile.
中性粒细胞减少性小肠结肠炎(NE),过去因其最常累及的胃肠道节段而被称为盲肠炎或回盲综合征,是一种难以诊断且发病机制至今尚未完全明确的疾病实体。最初在患有白血病的儿科患者中被描述,随后逐渐在患有血液系统恶性肿瘤和非血液系统疾病的成人中被报道,如白血病、淋巴瘤、多发性骨髓瘤、再生障碍性贫血,以及骨髓增生异常综合征,还与其他免疫抑制原因有关,如艾滋病治疗、实体瘤治疗和器官移植。因此,由于临床病情迅速恶化,它与高死亡率相关:迅速进展为缺血、坏死、出血、穿孔、多系统器官衰竭和败血症。:包含一个病例报告以举例说明发生败血症的NE患者的临床特征。:为了确定受中性粒细胞减少性小肠结肠炎影响的受试者的特定特征以及与败血症演变最常相关的临床状况实体,进行了一项系统的文献综述。纳入标准如下:英文、全文可获取、人类受试者和成年受试者。最后,在评估标题和摘要以评估其与本手稿主题的一致性后选择论文。按照这些程序,本综述纳入了19项符合条件的实证研究。:尽管最近人们对败血症感兴趣,针对败血症的出版物数量不断增加,旨在识别对其诊断、预后以及理解其发病机制有用的生物标志物,特别是对于多器官功能障碍,并且尽管文献综述的研究期很长,但关于“中性粒细胞减少性小肠结肠炎和败血症”主题的出版物数量似乎非常少。无论如何,推断的数据使我们能够得出结论,结合病史、临床和实验室数据、放射影像学以及宏观和组织学检查可以使我们识别出特定的病理特征。
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